Comparison of SARS-COV-2 seroprevalence and associated factors among people living with and or without HIV from selected health facilities in lira district

Abstract

Background: SARS-CoV-2, a highly infectious virus that causes COVID-19, has been a major global public health challenge in the last two to three years. Globally, approximately 616 million were infected and 6.54 million had died of COVID-19 as of September, 2022. Uganda, one of the countries battling with HIV pandemic with over 1.5 million people living with HIV, COVID-19 caused approximately 169 thousand cases and over 3600 deaths. Information on the burden of COVID-19 among people living with HIV (PLWHIV) compared to those without HIV in Uganda is not known. Objectives: To compare SARS-CoV-2 seroprevalence among PLWHIV and those without HIV and also determine the factors associated with SARS-CoV-2 sero status among PLWHIV attending selected health facilities.Methods: This was a comparative cross-sectional study conducted with 375 participants (181 HIV positives and 194 HIV negatives) recruited by stratified sampling method from three selected health facilities namely; Lira Regional Referral Hospital (LRRH), Pentecostal Assembly of God (PAG) mission hospital and Amach Health Centre IV in Lira district. Individuals who were vaccinated against COVID-19 and those who did not consent were excluded. Fingerstick blood samples were collected from each participant and tested for SARS-COV-2 IgG and IgM antibodies using FDA approved Panbio Abbott TM SARS-CoV-2 IgG/IgM rapid test cassette. In addition, a piloted structured interviewer administered questionnaire was used to collect data on factors associated with SARS-CoV-2 sero status among PLWHIV. Data were analyzed with STATA version 17 using modified poisson regression models at 5% level of significance and adjusted for clustering by reporting clustered robust standard errors with health facility as the clustering variable. Results: Overall SARS-COV-2 seroprevalence was 44.2% (95% CI; 13.5%-80.1%) among PLWHIV compared to 49.0% (95% CI; 3.4%-96.3%) among those living without HIV (p-value=0.355). The factors associated with SARS-COV-2 seroprevalence included having no formal education (aPR =0.379, p-value<0.001), tertiary (aPR =1.330, p-value<0.001) or university level of education (aPR =0.265, p-value<0.001), being a farmer (aPR =0.413, p-value=0.033) or having formal employment (aPR =0.709, p-value=0.011), Anglican (aPR =1.118, p-value=0.009) or Islam religion (aPR =0.716, p-value<0.001), not knowing at least one COVID-19 signs and symptoms (aPR =0.746, p-value<0.001) or preventive measures (aPR =2.124, p-value<0.001) and ever being in contact (aPR =0.587, p-value<0.001) or not knowing (aPR =0.329, p-value=0.010) if you had ever been in contact with confirmed COVID-19 patient or suspect. Conclusion: Overall seroprevalence was high, however, there was no significant difference in SARS-COV-2 seroprevalence among PLWHIV as compared to those without HIV. With high seroprevalence, we conclude that the exposure was significant so recommend preventive measures. We also conclude that university level of education or no formal education and being of Islamic faith and formally employed or a farmer with knowledge on at least one preventive measures of COVID-19 reduces the burden of COVID-19 among PLWHIV. Other factors like being in tertiary education level, being of Anglican faith and with knowledge of at least one signs and symptoms of COVID-19 added to the risk. Therefore, public health messages should emphasize the known protective practices e.g. social distancing during prayers, work-places.